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What is Cauda Equina syndrome?

Cauda equina syndrome (CES) is a very serious neurological condition caused by the damage to the cauda equina (a bundle of spinal nerves) which leads to severe compression of the nerves and a loss of function in the lumbar plexus at the bottom of the spinal cord.

Although a rare condition, CES can be extremely debilitating and should therefore be considered a surgical emergency.

The ‘cauda equina’ was named after it’s resemblance to a horse’s tail – cauda equina is Lating for ‘horse’s tail’.

What causes Cauda Equina syndrome?

CES is most commonly caused by a herniated disc in the lumbar region of the spine. These discs are positioned between the spinal column bones and act as ‘shock absorbers’ to help with the stress that is put on the spine.

A herniated disc occurs when the normally soft and flexible disc begins to break down, usually through ageing but the process can be exacerbated through stress or mechanical problems with the spine. When this occurs, the disc begins to push out and applies pressure to the nerve roots in the lumbar spine.

Other causes of cauda equina syndrome include:

spinal lesions and tumours

spinal infections or inflammation

lumbar spinal stenosis

trauma to the lower back

birth abnormalities

spinal arteriovenous malformations (AVMs)

spinal hemorrhages (subarachnoid, subdural, epidural)

narrowing of the spinal canal

postoperative lumbar spine surgery complications or spinal anesthesia

Cauda Equina symptoms

There are many potential long-term effects of cauda equina syndrome, which can include incontinence and paralysis. It is important therefore for doctors to quickly recognise the symptoms and warning signs of cauda equina symptoms. These include:

Severe back pain

Incontinence

Sexual dysfunction

Pain in one or both legs

If these symptoms are misdiagnosed, or there is a delay in diagnosing cauda equina syndrome, then the results can be devastating. If this happens then you could be entitled to make a medical negligence compensation claim.

Reasons for making a cauda equina syndrome compensation claim

Due to the nature of cauda equina syndrome, we have found that Claimant’s often experience specific medical negligence issues that many others do not. Some of these include:

Lack of awareness/knowledge of CES

Sometimes medical staff may not be fully aware of all the signs and symptoms of cauda equina, and are therefore not in a position to act fast with treatment and surgery.

Delayed MRI or CT scans

Claimant’s often report delays of days and even weeks before they have a scan, during which time their condition can deteriorate to such a level that permanent nerve damage is irreversible. If they had a scan immediately then permanent damage could have been avoided.

Misdiagnosis of cauda equina by GPs

While most GPs are fully aware of cauda equina and the importance for swift action, some may let down their patients by misdiagnosing the condition from the outset.

Poor surgery or surgical errors

A poor standard of surgery, or an error during surgery, can result in the patient’s condition worsening. It can also lead to the distressing prospect of more surgery.

Cauda equina compensation payout amounts

Although cauda equina claims are rare, when they settle they tend to be for high amounts. This is to reflect the devastating effects a delay in diagnosis and treatment can have.

The patient can often suffer long-term physical complications which hinder their ability to work or even live a normal life.

The amount of general damages (which reflects the level of pain, suffering and loss of amenity) and special damages (which reflects the acute financial loss) will therefore be very high.

Some compensation payouts for cauda equina syndrome can be as high as £500,000 or more, with an average compensation payout of around £120,000.